Related Experiment Video
Updated: Jul 4, 2026
An Intramedullary Locking Nail for Standardized Fixation of Femur Osteotomies to Analyze Normal and Defective Bone Healing in Mice
Published on: November 13, 2016
Comparison of intramedullary nailing to plating for both-bone forearm fractures in older children
Keith R Reinhardt1, David S Feldman, Daniel W Green
1Hospital for Special Surgery, New York, NY 10021, USA. reinhardtk@hss.edu
Insights
Intramedullary nailing and plating offer similar outcomes for forearm fractures in children aged 10-16. Nailing is quicker and equally effective for these pediatric fractures.
Area of Science:
- Orthopedic Surgery
- Pediatric Orthopedics
- Trauma Surgery
Background:
- Operative fixation of forearm fractures in children (10-16 years) is debated.
- Optimal fixation methods for pediatric forearm fractures require comparison.
Purpose of the Study:
- Compare radiographic and functional outcomes of intramedullary nailing versus plating for forearm fractures in children aged 10-16.
- Evaluate fracture union, forearm rotation, radial bow restoration, and complication rates.
Main Methods:
- Retrospective comparative study of 31 patients with midshaft radius and ulna fractures.
- Patients divided into intramedullary nailing (19) and plating (12) groups.
- Comparison of perioperative data and patient outcomes at 3 and 6 months, and latest follow-up.
Main Results:
- Nailing group had significantly shorter surgery duration and tourniquet time.
- No significant differences in fracture union at 3 or 6 months between groups.
- Similar radial bow magnitude and forearm rotation; radial bow location differed in the nailing group.
- Comparable complication rates between nailing and plating groups.
Conclusions:
- Intramedullary nailing is an equally effective fixation method compared to plating for length-stable forearm fractures in skeletally immature patients (10-16 years).
- Nailing is a viable and preferred treatment option due to similar functional and radiographic outcomes.
- Both methods achieve normal radial bow magnitude and restore forearm rotation.
Background:
When operative stabilization of forearm fractures in older children is necessary, the optimal method of fixation is controversial. This study compared the radiographic and functional outcomes of intramedullary nailing to plating of forearm fractures in children between 10 and 16 years of age.
Methods:
Thirty-one patients who underwent operative fixation of midshaft radius and ulna fractures were divided into nailing and plating groups and were compared retrospectively according to perioperative data and patient outcome measures (fracture union at 3 and 6 months, loss of forearm rotation, restoration of radial bow magnitude and location, and complication rates).
Results:
The nailing group had 19 patients, with a mean age of 12.5 years (range, 10-14.6 years), and the plating group had 12, with a mean age of 14.5 years (range, 11.9-16 years). Groups were similar for sex, arm injured, fracture location, Arbeitsgemeinschaft fur Osteosynthesefragen/Orthopaedic Trauma Association classification, and number of open fractures. Duration of surgery and tourniquet use were significantly shorter in the nailing group (P = 0.037 and 0.001, respectively). No differences were found between the groups for fracture union at 3 or 6 months. At latest follow-up, radial bow magnitude was similar for the 2 groups and restored to normal in both. Radial bow location in the nailing group was significantly different from the reported normal values (P = 0.001). Despite this, there was no difference in loss of forearm rotation between groups. Complication rates were also similar between groups, with 1 ulna nonunion, 1 compartment syndrome, and 2 refractures in the nailing group and 1 radius and ulna nonunion, 1 broken plate, and 2 refractures in the plating group.
Conclusions And Significance:
Based on similar functional and radiographic outcomes, nailing of length-stable forearm fractures remains an equally effective method of fixation in skeletally immature patients 10 to 16 years of age when compared with plating and is our treatment of choice.
Level Of Evidence:
Therapeutic level III--retrospective comparative study.
More Related Videos
04:41Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
Published on: June 6, 2025
11:21Development of a Novel Internal Fixation Model for Rat Radial Fractures: Fracture Healing Assessment and Dorsal Root Ganglion Isolation
Published on: March 13, 2026
